Week of January 5, 2026
A few weeks off from writing yielded a backlog of articles. And while I enjoy time off, moving from days filled with information firehoses and multitasking to watching waves and sand crabs can be torturous. My subconscious efforts to stay busy on our Puerto Rican vacation manifested in some amusing ways - a multi-day hunt for our rental car's airtag (I kept getting the "unknown airtag is moving with you" notices), fixing random things at our Airbnb (I should get a discount for fixing toilets and tightening squealing door hinges!), and developing a business plan for an AI-enabled, clinical monitoring and micro-learning luxury portable toilet company (who wouldn't want to learn about their urinary milieu with TikTok-style videos generated in real time?). Idle hands may be the devil's tools, but an idle mind is my personal purgatory.
Unsurprisingly, some psychologists study this—researchers on affective forecasting and happiness. Perhaps they could offer an emotional weather channel for future vacation plans? Here is a 2010 article from Science: "A Wandering Mind is an Unhappy Mind."
AI-assisted Summary
The Google Notebook LM AI-generated podcast version of this week's newsletter.
Science and Technology Trends
This article became a topic of conversation during our holiday vacation. A group of economists sent 36,880 fake resumes (of simulated newly graduated college students applying for their first job) to real job postings (for business-related roles) to see how various majors, college activities, and other experiences (like study abroad) impact the initial callback rate. Their data revealed that Biology and Economics majors get called back 13-15% more often than Philosophy majors for business jobs, but surprisingly, having a Math or History minor makes absolutely no difference. Internships involving sales and people skills boost callbacks, while analytical internships don't. Minors (and related studies that typically require 18-25 credit hours of coursework) delivered zero change in the rates of an initial callback.
Paper:
AI-assisted summary:
Last week, I came across a study examining the risk of bacterial adherence to healthcare workers' fingernails in hospital settings. 46 hospital staff had manicures in which different fingers received gel nail polish, regular nail polish, or no nail polish. Then, researchers swapped their nails before and after handwashing over the next few weeks. By day 21, gel-polished nails had significantly lower bacterial counts than bare nails or standard polished nails. Standard polish demonstrated the highest bacterial burden from day 4 onward. Alcohol-based hand sanitizer effectively reduced bacteria across all nail types. (To think how many times I've denied myself an attractive manicure due to unfounded infection control concerns.)
Article:
AI-assisted analysis:
As one might imagine, I am very aware of the "hospital's germ-filled environments" issue. When I used to see inpatients, I stopped carrying water bottles, stopped wearing ties and jewelry, and wiped down my cell phone daily. Here is an article on why neckties are fomites - bacteria-covered biological weapons that rarely get cleaned.
Likewise, white coats are problematic. Though they engender confidence and project professionalism, they are also infrequently washed (despite coming into contact with a plethora of surfaces, including the clinician's car). Here is a review of the trade-offs of wearing white coats that concludes, "To mitigate contamination risks, it is recommended that physicians roll up coat sleeves during examinations and that the coats receive daily laundering in healthcare settings."
I enjoyed The Guardian's "Everything science taught us about health and wellness in 2025" article.
They captured numerous studies that make for good dinner-table conversation. Bear in mind that much of this is anecdotal and associative. Here are the studies and articles referenced in the roundup:
| Topic | What the Research Demonstrated | Type & Scale of Study |
| Collagen | Randomized Trial: Small (Young men, 16 weeks) | |
| Beetroot | Experimental Trial: Small (University of Exeter, 2 weeks) | |
| Pickle Juice | Experimental: Small controlled trials (England Football team usage) | |
| Creatine | Reviews: (Nutrition Reviews & J. Int. Soc. Sports Nutr.) | |
| Fruit | Associative: Large (UK Biobank, ~150k adults) | |
| Hydration | Randomized: Small (Healthy young adults, 1 week) | |
| Coffee | Associative: Large (European Heart Journal) | |
| Hot Baths | Randomized RCT: Small (20 trained adults, 6 weeks) | |
| Cold Water | Experimental: Small (Young athletes, Sept 2025) | |
| Internet Addiction | Associative: Moderate (889 adolescents) | |
| Screens & Sports | Longitudinal: Small (Volleyball players, 30 days) | |
| Sedentary Time | Associative: Moderate (~400 older adults) | |
| Sex | Associative: (Psychological Science & Eur Heart J) |
Here is a single linkable list:https://docs.google.com/document/d/19ZHG9og8GZhUKAE1NmW5Fiz2DvFSKrQqTgYZP7SRVl0/edit?usp=sharing
Anti-Anti-Science
Two social psychologists demonstrated a great example of overlapping cognitive biases that impact public policy - the (false) perception of moral decline (colloquially experienced as the 'kids these days' comments and Make [something] Great Again sentiment). The researchers used layers of both current and historical data to show that for at least 70 years across 60+ countries, people report moral decline, but quantitative data from those reports haven't changed. These data strongly suggest the 'moral decline' belief is an illusion perpetrated by current negative news (a framing and recency bias), and a tendency to forget past negative (rosy retrospection).
Article:
AI-assisted Summary:
JAMA published this extensive, real-world study offering robust evidence that COVID-19 vaccines substantially reduced the serious risk of pregnancy complications. The study (n = 19,899) demonstrated that, among individuals with SARS-CoV-2 infection in pregnancy, COVID-19 vaccination was associated with a lower risk of maternal hospitalization and critical care unit admission, as well as preterm birth, during both the Delta and Omicron variant time periods.
Article:
AI-summarized analysis:
Beer-based vaccines could help overcome vaccine hesitancy. Chris Buck, an NIH virologist, has engineered brewer's yeast to produce BK polyomavirus virus‑like particles and used it to brew "vaccine beer" that he and family members have consumed, generating BK antibody responses without reported adverse effects but with no formal trials or peer review. (N.B. - home beer makers should not attempt to brew beer with genetically-engineered yeast for these purposes.)
Article:
Related: Beer has been a consistent, significant source of scientific breakthroughs:
More related: A video of Dr. Paul Offit explaining the pediatric vaccine schedule and related science to a vaccine-skeptical mother:
AI and Its Impact
Charlotte Blease is a professor of health informatics at Sweden's Uppsala University and an instructor at Harvard Medical School. She writes about AI ethics in healthcare. Over the holidays, I came across this thoughtful excerpt from her book, Dr Bot: Why Doctors Can Fail Us – and How AI Could Save Lives (2025).
Essay:
AI-assisted Analysis:
Google and Carnegie Mellon researchers explore how AI models (and their black-box-trained neural networks) build internal "maps" of related concepts clustered spatially, even for relationships they were never explicitly taught. The analysis suggests AI models are synthesizing a type of "world model" from fragments, which could explain both their reasoning abilities and their failures.
Article:
AI-assisted Analysis:
When large language models generate medical summaries or treatment plans, they often make confident-sounding errors because they never explicitly defined what they were reasoning about in the first place. This paper proposes "Model-First Reasoning"—forcing AI to first write down the relevant entities, rules, and constraints before attempting to solve a problem—essentially requiring the AI to show its work before answering.
Article: https://arxiv.org/abs/2512.14474
AI-assisted Analysis:
Things I learned this week
We experienced Puerto Rico's beautiful (and relatively quiet) beaches, a super-friendly, vibrant culture, and peripatetic urban horses. PR is also home to the world's largest concentration of bioluminescent (light-emitting) dinoflagellates (a type of plankton not in any way related to gaseous dinosaurs). To commune with these unique plankton, one must fly to Puerto Rico, take a ferry to the island of Vieques, drive to Mosquito Bay at sunset, walk through calf-deep mud in a mangrove swamp in the dark, get in a kayak, and paddle into the bay with a certified guide. Then you literally hit the water. (The plankton are biomechanical, and the billions of Pyrodinium bahamense will light up when struck with a mechanical force like your hand or a kayak paddle.)
And yet, my nephrology nerd brain found the plankton a side show - a sort of biological one-trick pony - each dinoflagellate can light up about 7 times per night before having to re-energize via photosynthesis the next day, (only a few shows a night, like dancers at the Moulin Rouge?) The most fascinating biology was the mangrove trees surrounding the bay. Mangroves, it turns out, filter water similar to dialysis machines - efficiently separating salt from the brackish water, gathering oxygen with aerial roots while living in thick, anoxic mud (which may never come off my feet). Of course, all of this to say, now I know how mangrove trees deal with salty water (and you can too).
and
Here is your infographic of the week - how mangrove trees handle saltwater
AI art of the week
A visual mashup of topics from the newsletter, and an exercise to see how various LLMs interpret the prompt. I use an LLM to summarize the newsletter, suggest prompts, and generate images with different LLMs.
A visual mashup of topics from the newsletter, and an exercise to see how various LLMs interpret the prompt. I use an LLM to summarize the newsletter, suggest prompts, and generate images with different LLMs.
"Surrealist composition inspired by Antonio Martorell: Mangrove tree cross-section with roots transforming into dialysis tubing, filtering glowing blue-green water. Bioluminescent dinoflagellates float like constellations around the tree. Puerto Rican beach at twilight with scattered medical books, microscopes, and white coats hanging from palms. Vibrant tropical colors - deep teals, bioluminescent greens, sunset oranges. Bold lines, mixed-media texture, magical realism meets medical science."
See the full prompt I used here: https://claude.ai/public/artifacts/47ac453b-b89d-4f93-99d2-8e3b91b583e5
Epidemiologic Realities
This newsletter began during the pandemic. I leave these links here as a marker of 1) how to find resources on incidence and prevalence of various diseases and 2) to remind myself why I wear masks in my clinic and, often, on planes.
Measles is still spreading.
and
Wastewater Scan offers a multi-organism wastewater dashboard with an excellent visual display of individual treatment plant-level data.
https://data.wastewaterscan.org/
https://data.wastewaterscan.org/
The Pandemic Mitigation Collaborative (PMC) uses wastewater viral RNA levels to forecast COVID-19 rates over the next 4 weeks.
https://pmc19.com/data/
https://pmc19.com/data/
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Clean hands and sharp minds,
Adam
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